How To Use CPT Code 74170

CPT 74170 refers to a computed tomography (CT) scan of the abdomen with and without contrast material, used for diagnosing and treating abdominal conditions. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 74170 procedures.

1. What is CPT 74170?

CPT 74170 is a medical billing code used for computed tomography (CT) scans of the abdomen, performed both with and without contrast material. This diagnostic imaging procedure helps healthcare providers diagnose and treat various abdominal conditions by obtaining detailed cross-sectional images of the patient’s abdomen.

2. 74170 CPT code description

The official description of CPT code 74170 is: “Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections.”

3. Procedure

1. The patient is appropriately prepped and positioned on the CT scanner table.
2. Cross-sectional images of the abdomen are obtained without contrast material and displayed on the monitor screen.
3. Contrast material is injected into the patient.
4. Additional cross-sectional images of the abdomen are obtained with the contrast material and displayed on the monitor screen.
5. A radiologic technician typically performs the procedure, while a radiology provider interprets the data and performs the analysis.

4. Qualifying circumstances

Patients eligible to receive CPT code 74170 services are those who require diagnostic imaging of the abdomen to aid in the diagnosis and treatment of abdominal conditions. Examples of such conditions include, but are not limited to, abdominal pain, masses, infections, inflammation, and suspected malignancies. The healthcare provider must determine the medical necessity of the CT scan based on the patient’s clinical presentation and medical history.

5. When to use CPT code 74170

It is appropriate to bill the 74170 CPT code when a healthcare provider orders a CT scan of the abdomen both with and without contrast material to diagnose and treat abdominal conditions. The provider must ensure that the procedure is medically necessary and supported by the patient’s clinical presentation and medical history.

6. Documentation requirements

To support a claim for CPT 74170, the following information must be documented:

• Patient’s demographic information, including name, date of birth, and insurance information.
• Medical history and clinical presentation, including symptoms, physical examination findings, and any relevant laboratory or imaging results.
• Indication for the CT scan, including the suspected diagnosis or condition being evaluated.
• Details of the procedure, including the date, time, and location of the CT scan, as well as the name of the radiologic technician who performed the procedure and the radiology provider who interpreted the results.
• Findings and interpretation of the CT scan, including any abnormalities or relevant findings related to the patient’s condition.
• Any recommendations or follow-up care based on the CT scan results.

7. Billing guidelines

When billing for CPT code 74170, keep the following guidelines in mind:

• For CT abdomen without contrast, report CPT 74150.
• For CT abdomen with contrast, report CPT 74160.
• If reporting only the physician’s interpretation for the radiology service, append professional component modifier 26 to the radiology code.
• If reporting only the technical component for the radiology service, append modifier TC to the radiology code. Note that payer policy may exempt hospitals from appending modifier TC because the hospital’s portion is inherently technical.
• Do not append a professional or technical modifier to the radiology code when reporting a global service in which one provider renders both the professional and technical components.

8. Historical information

CPT 74170 was added to the Current Procedural Terminology system on January 1, 1990. The code was changed on January 1, 2003, from “Computerized axial tomography, abdomen; without contrast material, followed by contrast material(s) and further sections” to its current description.

9. Similar codes to CPT 74170

Five similar codes to CPT 74170 and how they differ are:

• CPT 74150: CT abdomen without contrast material.
• CPT 74160: CT abdomen with contrast material.
• CPT 74176: Combined CT abdomen and pelvis without contrast material.
• CPT 74177: Combined CT abdomen and pelvis with contrast material.
• CPT 74178: Combined CT abdomen and pelvis without contrast material, followed by contrast material(s) and further sections.

10. Examples

Here are 10 detailed examples of CPT code 74170 procedures:

1. A patient presents with unexplained abdominal pain, and the healthcare provider orders a CT scan of the abdomen with and without contrast to evaluate for possible appendicitis.
2. A patient with a history of colon cancer undergoes a CT scan of the abdomen with and without contrast to monitor for potential metastasis or recurrence.
3. A patient with suspected Crohn’s disease undergoes a CT scan of the abdomen with and without contrast to assess the extent of bowel inflammation and complications.
4. A patient with a palpable abdominal mass undergoes a CT scan of the abdomen with and without contrast to determine the nature and origin of the mass.
5. A patient with a history of abdominal trauma undergoes a CT scan of the abdomen with and without contrast to evaluate for internal injuries and bleeding.
6. A patient with suspected liver abscess undergoes a CT scan of the abdomen with and without contrast to confirm the diagnosis and guide treatment planning.
7. A patient with unexplained weight loss and night sweats undergoes a CT scan of the abdomen with and without contrast to evaluate for possible lymphoma or other malignancies.
8. A patient with a history of pancreatitis undergoes a CT scan of the abdomen with and without contrast to assess the severity of the condition and monitor for complications.
9. A patient with suspected diverticulitis undergoes a CT scan of the abdomen with and without contrast to confirm the diagnosis and assess the extent of inflammation.
10. A patient with a known abdominal aortic aneurysm undergoes a CT scan of the abdomen with and without contrast to monitor the size and stability of the aneurysm.